Provider Demographics
NPI:1669673539
Name:BRIGGS OPTICAL TWO LC
Entity Type:Organization
Organization Name:BRIGGS OPTICAL TWO LC
Other - Org Name:DBA PEARLE VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIGGS
Authorized Official - Suffix:SR
Authorized Official - Credentials:OPTICIAN
Authorized Official - Phone:239-594-3555
Mailing Address - Street 1:15495 TAMIAMI TRL N
Mailing Address - Street 2:SUITE 124
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-6206
Mailing Address - Country:US
Mailing Address - Phone:239-594-3555
Mailing Address - Fax:239-594-3504
Practice Address - Street 1:15495 TAMIAMI TRL N
Practice Address - Street 2:SUITE 124
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-6206
Practice Address - Country:US
Practice Address - Phone:239-594-3555
Practice Address - Fax:239-594-3504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDO5720156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty